Bone Marrow Lesion: Image, Clinical Presentation, and Treatment

Area of Science:

• Orthopedics
• Radiology
• Rheumatology

Background:

• Bone marrow edema (BME) is a non-specific finding on MRI, typically indicating fluid-sensitive signal alterations.
• The clinical significance and prognostic implications of BME are gaining attention, particularly in relation to osteoarthritis.
• Subchondral insufficiency fractures are increasingly recognized as a cause of BME.

Purpose of the Study:

• To comprehensively review the etiology, histology, imaging features, clinical presentation, and management of bone marrow edema.
• To discuss the correlation between bone marrow lesions and patient-reported pain and osteoarthritis progression.
• To explore current and developing treatment strategies for BME.

Main Methods:

• Literature review and synthesis of existing research on bone marrow edema.
• Discussion of diagnostic imaging characteristics, focusing on MRI fluid-sensitive sequences.
• Analysis of clinical presentations and treatment outcomes.

Main Results:

• Bone marrow edema is associated with joint pain and can correlate with osteoarthritis progression.
• Conservative management includes anti-inflammatory drugs, analgesics, and reduced limb loading.
• Subchondroplasty shows promising initial results as a developing surgical treatment option.

Conclusions:

• Bone marrow edema is a significant finding with implications for joint health and prognosis.
• Further research is needed to fully elucidate the role of BME in osteoarthritis and refine treatment approaches.
• Subchondroplasty represents a potential future therapeutic avenue for specific BME cases.